Give Thanks

Thanks for giving me great hugs daddy. I love you.

I am also thankful nana's cancer was found only in the uterus and not in any lymph nodes! No chemo or radation needed right now!! I love you.

Livestrong

My Mommy often tells me I am a livestrong baby. Well today my nana needs some of my lifestrong powers since she is having surgery for clear cell endometrial cancer. I really hope it goes well because I love her sooooo much. Hopefully she can tell I am sending livestrong vibes to her :)

Cancer Remission Update

Just wanted everyone to know that last week Dan had his testicular cancer remission check. All his blood work and CT-Scans came back great. Cancer is still in remission, no changes on the CT-Scan and not another check until January 2010 (doesn't 2010 seem years away?!) Thanks to everyone for their continued thoughts about Dan and our family!

Bye Nana!

Today was a sad day, my mom drove back to Florida after spending 3 weeks with us. She was such a big help playing with the baby, giving us time to sleep and helping feed the baby the breastmilk that I was pumping every few hours - she will definately be missed!

Today was fun though -- we went in for Dex's 2week checkup. He is back up to 8 pounds 12 ounces, 21 inches long and his head is a whopping 38cm around. This puts him right in the 50-60th percentile of other babies his age. After visiting the pediatrician we took Dexter to the oncology department to show him off to the nurses that worked on Dan during his chemo. They all loved him and were happy to see Dexter and Dan looking so good - hopefully the next time they have a young testicular cancer patient they mention them and the power of sperm banking!

No evidence of metastatic disease

I had my 9-month post-chemo CT scan on Friday 30-Jan-2009, and have just spoken with Cindy in the Oncology department. She read back the results of the scan, and they indicate a stable lower quadrant with no evidence of cancer. I have an appointment with the Oncologist at the end of the month to prepare documentation for a possible extension to my Code-C profile (they call it C-Code, but that means something else to a programmer =P). So far, so good.

Last week I also found out that an article I wrote had been accepted into the Peer-to-Peer Networking and Applications (PPNA) journal. Journals are generally regarded as more important than (most) conferences because they are peer reviewed and highly selective. This is a huge milestone toward my doctorate, and relieves a lot of pressure. I still have to submit two more articles, write the dissertation, and defend my work before I can graduate.

CT Scan

No changes. Remission continues. One more scan in 3months and then we move to every 4month scans for 1 year!

http://www.karrels.com/cancer/CT_Scan_7_Jan_2009.pdf

CT Scan Results 9-Oct-2008

"Stable examination with no evidence of residual or recurrent disease."

3 month CTScan - A ok!

Dan called the oncology nurses today to have them read the results to him since he will not be meeting with Dr. Wood until July 10th. They said it was good - no changes from the last CT-Scan. Still an area of scar tissue that apparently is no bigger or smaller than previous and should appear the same on future CT Scans. So Dan continues down his path to remission. Perhaps on the 10th we will scan in the actual report so the medical types that follow this blog can read it. Very good news for us, next scan in 3 months (10/1/08)

Little Updates

First off tomorrow Dan has his 3 month checkup CT Scan. It will be another week or so until we meet with the doctor for the report, but as soon as we know it we will pass it along. On a personal note Dan has decided to start riding motocross again. He has bought a bike, gear and a trailer already. Most are being delivered this week to us. The bike we need to drive up to Ann Arbor Michigan to pick up. This is something Dan has done since he was like 3 years old and easily his favorite activity despite all the risks and injuries that have gone with it. There are several tracks within an hour of Dayton so plenty of places for him to ride around in the mud.


As for me, tomorrow I officially start the IVF protocol. I start on birth control pills for 3 weeks in order for them to time easier all the other shots and tests they need to do and also help prevent any nasty cysts from forming again.

And on a scary note, my little nephew Cole is vacationing in NC this week. Well apparently yesterday Cole was eating with the family and started choking. His little face looked scared and he was making no noise at all. Heather luckily had read an infant first aid book my mom had given her (All parents NEED to take infant/child CPR) and was able to start back blows/chest thrusts and eventually he spit up the fruit cocktail that was blocking his air. Needless to say everyone there was very shook up and crying. I cant even imagine how scared Heather must have been and so thankful that Cole is ok.

Chemo Fingers!

I was watching an episode of CSI, and one of the victims in the show was shown to have transverse white lines across his fingernails. The show went on to say that it was a side effect of heavy metal poisoning, and the lines on the fingernails represented separate significant events of poisoning of the victim.

I happened to look down at my own fingernails and, wouldn't you know it, I have transverse white lines on all 10 fingernails (didn't check toes). One of my fingers is shown on the right. We had trouble finding a camera that could take good close up photos, and the lines are actually more pronounced in real life than shown here.

As it turns out, CSI was correct about the causes of the white lines. They are results of heavy metal poisoning (which I don't have), and also caused by fever, liver or heart disease, iron deficiencies, and a number of similar conditions. As it turns out, the chemotherapy treatment I received caused me to become anemic during treatment.

They tested me before entering into each phase of chemotherapy, and going into the final round the doctor said my counts (anemia) were low enough that I might have to get daily injections to combat it so treatment could continue. Of course, I talked him out of such a course.

Notice there are three lines on the fingernail above, one for each cycle of chemotherapy. If I can find time, Capt's McCall and Rutledge and I will perform an image analysis of the fingernails and attempt to determine the exact times these events occurred, although I doubt if any of us would be surprised of the results :)

Edit - Thanks to Jeff I know I was heavy metal poisoned!!

All Good in Indiana

We drove the 2 hours to IU today. It was nice to be on a college campus again. Lots of nice brick buildings and young adults walking & biking around. We met with Dr. Foster, who was the urologist surgeon that we were referred to. He reviewed the lab work and scans that we brought. He defiantly thinks observation is the only route to do right now. Since the PET scan didn't show any live cancer activity we have to assume the nodes that showed on the CT-Scan are dead cancer and will get reabsorbed by the body in time. Basically every 3month CT-Scans for the 1st year is the plan of action! We are glad we got the 2nd opinion and are happy to say that nothing more is planed for Dan medically for a while. After a couple rounds of good CT-Scans we can officially say he is in remission.

Meeting set for IU

We have our meeting with Indiana University set for Thursday, April 24th at 12:30. Hopefully things will go well! We are driving to IU, it should take about 2.5 hours.

I still have my surgery set for Tuesday, April 22nd.

CT images

Here are 4 images of Dan's abdomen. 2 are pre-chemo, the lymph nodes are green. 2 are post-chemo, the shrunken lymph nodes are yellow, calcified one is purple. As you can see there is a dramatic reduction in the size of the lymph nodes which is great! Ideally they would be all gone but this is pretty good as well. The ones that are remaining are one of three things: Active cancer that is just shrunk, residual lymph nodes that have yet to be reabsorbed by the body but will in time, or scar tissue that will present as an abnormality for years to come.

You should be able to click on all these images to make them bigger.

Pre-Chemo CT Scan












Post Chemo CT Scan

We also reviewed the results of the PET Scan. The scan was further good news, as it was basically negative for any cancer activity. There was only a very small flash of activity seen on a couple slices of the scan.

So if we put all this information together, its looking like observation and not surgery will be the route we take. Repeat CTScans every 3months for a year. See if the area shrinks (being reabsorbed), stays the same (scar tissue) or grows (cancer).

We still are pending our referral approval to go to Indiana University. All our doctors here are hopeful that we can go observation route but they all say that if IU thinks surgery is whats needed than we have to do it. We have a 1/3 chance that its active cancer and if IU thinks the risk is too much we can go and take it out, but like I said before the surgery is not a minor one so hopefully it wont come to that.

This Week

Dan's PET Scan is scheduled for Wednesday and his meeting with Dr. Hoopes is for Friday at 9:30 to review everything.

Refered to Indiana

We met with Dr. Lewis this morning. He was "very concerned" about the calcified lymph node from the right paraarotic region. He said it is a little bit smaller, but really is an abnormal finding and he would really feel more comfortable for the experts at Indiana University to review the CTscans, lab work, etc and see if they want to surgically remove the node. The surgery would be a paraaortic lymph node dissection. Dr. Lewis said there is about a 20% chance that the lymph node has active cancer in it. We could choose to wait and obverse it through routine CTScans or we can do the surgery. He really thinks we should just gather all the data and see what the doctors in Indiana want to do. The surgery is not a minor one by any means. This is a highly specialised operation and is not available at all treatment centers. The paraarotic nodes are right along the major artery in your abdomen and also run near nerves. Dan would be in the hospital for 1-3 days on average depending on if they do it open or laprascopic. It would be done by a vascular surgeon or a general surgeon who has experience with this type of surgery. There is still a chance we do nothing, but we will have to see what Indiana says. It will probably take a couple weeks to get everything approved before we go there. We will keep you updated.

Radiology Report

As you can see, it is rather cryptic: page 1, page 2.

Meeting with Dr. Woods (updated)

Well today we met with Dr. Woods. I guess I went into the meeting assuming a black and white answer. But we left with a grey one. Dr. Woods read us the radiology report from his CT-Scan.
"Lungs: No masses, effusions or infiltrates are detected. No mediastinal or hilar adenopathy is observed."
So, no tumors or Large lymph nodes in the chest - Yea!

"No abnormalities of the spleen, pancreas, gallbladder, adrenal glands or kidneys are appreciated. Stable, small cysts in the liver consistent with 03-Jan-08 study"
All looks good so far - Yea!

"A dense calcified lymph node is again visualized in the right paraarotic region. Adjacent necrotic lymph node is no longer seen. Instead, small amount of decreased density is present adjacent to the anterior right aorta. Previously noted paracaval and pelvic adenopathy seen on prior examination is also no longer visualized. No abdominal or pelvic masses are appreciated."
Dr. Woods was going to talk with the radiologist and see what he thought of the "small amount of decreased density and dense calcified lymph node " comment. But overall he said its good. - Cautious Yea!

"CT Overall Impression - Interval Resolution of previously noted retoperitoneal adenopathy"
interval? I wanted to see the words complete resolution.


So you all know all we know now. Tomorrow we meet with Dr. Lewis, the surgeon, at 8:30. We will see what he thinks of the CT-Scan and if any thing needs to be done from his standpoint. We are also going to call Dr. Hoops and see if he will met with us and go over the CT-Scan with models again. There is also the weekly tumor board meeting every Wednesday. So after they met next Wednesday if Dr. Woods thinks anything needs to be done he will call us.


EDIT: Dr. Wood just called. Here is what he said: - Dr. Hoops is out of town, but will be back early next week. Dr. Wood did leave a message on his voicemail. - Calcified lymph node: probably lymph node shrunken but not gone, it could be a tumor or scar tissue. Dr. Wood said we should get a PET scan (and he is ordering it). The only problem with the PET scan is that the false negative rate is 10-15%. - Current options: observation, surgery, or radiation therapy Some of the blood work has come back: - Electrolytes are normal - Liver activity is normal - Anemic, 10.4 hgb - White blood cells normal - Platelettes are normal - Beta HCG normal - LDH tumor marker elevated. Probably as a result of chemo (peaked at 397 during chemo), it's at 216 now, with a normal cutoff of 190

No word yet...intermission

Dan's CT Scan was today, he has an appointment Thursday at 9:30 with his oncologist. Unless we hear earlier we assume we will get the results at that time.



This youtube video reminds me so much of Ophelia right now. Pretty much since we moved to Ohio she has been getting ear infections. Just Sunday she went to the vet for a steroid shot and a ear cleaning. She is now on once a day pill, twice a day ear drops and hypoallergenic food. She is allergic to Ohio, she never had any health issues when we lived in Florida!

Air Force Boards, part 2

Dan got the result today of the AF boards. They placed him as a C3 for 1 year. In other words, he cant get deployed for a year (gosh, so sad..) Course he still has 2 years or so on his PhD program so doesn't really matter. Good news is he is still a member of the AF and our 30year plan is still in place.

april fools

Dan's CT-Scan is scheduled for April 1st, 2008. Nothing much more to report, just wanted you guys to know the date.